New Technology Could Allow Surgery on the Unborn

Spina bifida is one such disease, affecting approximately 1 in 2,500 newborns worldwide, where a lesion on the back leaves the spinal cord exposed in the womb, leading to severe disabilities, learning difficulties, and sometimes death.

The best option is to perform surgery to correct the problem before the baby is born but the complexities of such a procedure mean this currently only takes place in five countries worldwide. Most countries instead perform surgery after a child is born, but when the majority of damage has been done.

To reduce the risk involved in fetal surgery, scientists at University College London (UCL), and KU Leuven in Belgium are developing a miniscule robotic arm to enter the womb with minimum disruption to mother and baby. The robotics are targeting spina bifida but also lesser known conditions such as twin-twin transfusion syndrome, where blood passes unequally between twins who share a placenta, and fetal lower urinary tract obstruction, where babies are unable to urinate in the womb and their bladders become large and distended.

Surgery on fetuses has been effective in treating some conditions to date, but for spina bifida, the risks to mother and baby mean surgery is currently only performed in a handful of countries, where specialist teams exist.

"Most birth defects can be prevented if we can intervene earlier," says Professor Sebastien Ourselin, from the UCL Center for Medical Image Computing, who is leading the new research project. "But currently, surgical delivery systems are not available and operating on babies in the womb is reserved for just a handful of the most severe defects as risks are too high."